title: Long-term follow-up evaluation of revisional gastric bypass after failed adjustable gastric banding.
abstract: BACKGROUND
  Disappointing long-term results, frequent band failure, and high rates of band-related complications increasingly necessitate revisional surgery after adjustable gastric banding. Laparoscopic conversion to gastric bypass has been recommended as the procedure of choice. This single-center retrospective study aimed to evaluate the long-term results of revisional gastric bypass after failed adjustable gastric banding.
  
  
  METHODS
  The study included 108 consecutive patients who underwent laparoscopic conversion of gastric banding to gastric bypass from 2002 to 2012. Indications for surgery, operative data, weight development, morbidity, and mortality were analyzed. The median follow-up period was 3.4 years (maximum, 10 years).
  
  
  RESULTS
  The most common indications for band removal were band migration, insufficient weight loss, and pouch dilation. The median interval between gastric banding and gastric bypass was 6.6 years. In 52 % of the cases, band removal and gastric bypass surgery were performed simultaneously as a single-stage laparoscopic procedure. The early postoperative morbidity rate was 10.2 %. The body mass index before gastric banding (43.3 kg/m(2)) decreased significantly to 37.9 kg/m(2) before gastric bypass and to 28.8 kg/m(2) 5 years after gastric bypass.
  
  
  CONCLUSIONS
  This is the first report on the long-term outcome after conversion of failed adjustable gastric banding to gastric bypass. Findings have shown revisional gastric bypass to be a feasible bariatric procedure particularly for patients with insufficient weight loss that guarantees a constant and long-lasting weight loss.
authors.affiliation: Department of Visceral, Transplant, and Thoracic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria, alexander.perathoner@i-med.ac.at.
authors.forename: Alexander
authors.initials: A
authors.lastname: Perathoner
authors.forename: Matthias
authors.initials: M
authors.lastname: Zitt
authors.forename: Monika
authors.initials: M
authors.lastname: Lanthaler
authors.forename: Johann
authors.initials: J
authors.lastname: Pratschke
authors.forename: Matthias
authors.initials: M
authors.lastname: Biebl
authors.forename: Reinhard
authors.initials: R
authors.lastname: Mittermair
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002755:Choice Behavior; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods* / Q000401:mortality; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D015996:Survival Rate; D017211:Treatment Failure; D015431:Weight Loss; D055815:Young Adult